While Democrats and Republicans in Congress continue to argue about health insurance premiums for tens of millions of Americans, the deadline to sign up for coverage under the Affordable Care Act has not changed.

Anyone who missed the Dec. 15 deadline to sign up for coverage to start Jan. 1 has until Jan. 15 to select coverage to start Feb. 1.

Unless Congress does something in the next couple of weeks to extend enhanced federal subsidies, monthly premiums for policies under the Affordable Care Act will increase — by hundreds of dollars and in some cases by more than $1,000 a month — for more than 20 million Americans, including almost 29,000 Alaskans.

Alaska Republican Sens. Lisa Murkowski and Dan Sullivan, and two other Republicans, joined Senate Democrats on Thursday, Dec. 11, in voting to extend the federal subsidies. But the 51 votes were far short of the 60 needed to advance the bill. An alternative Republican-backed bill also went down to defeat.

“I would just suggest that we have failed,” Murkowski said in a floor speech following the votes.

Several senators are continuing to work this week to find a compromise that could win enough votes in the Senate and House, and the president’s approval, to avoid steep insurance premium increases.

Callers to the SEARHC patient benefits office for help with sign-up through the federal marketplace “are more anxious and more worried,” said manager Susan Briles.

“Some people have just given up and are not calling,” she said. “Our phones are more quiet than in past years,” Briles said a week before the first deadline of Dec. 15.

Many callers say “they likely cannot afford insurance” without the enhanced subsidy and will go without coverage, she said.

Briles, however, recommends people at least call and let the office work up premium estimates at different levels of coverage. The monthly cost depends on a person’s income and household size.

For 2025, more than 100 people in Wrangell had policies through the federal marketplace, according to the Centers for Medicare & Medicaid Services.

In 2020, when 100 Wrangell residents had policies, 86 benefitted from the federal subsidies, bringing down their monthly premiums by an average $690, according to federal statistics.

Of those 86, more than two dozen paid less than $10 a month.

The 2025 numbers around Southeast, according to the Centers for Medicare & Medicaid Services, show 289 marketplace policies in Petersburg, 544 in Sitka, 601 in Ketchikan and 1,301 in Juneau.

Statewide, almost 29,000 Alaskans signed up for policies in 2025, at an average cost of $223 a month — which would have been $1,105 a month without the federal help. More than 7,000 people paid less than $10 a month, according to the federal statistics.

The federal marketplace offers three levels of coverage — gold, silver and bronze — with more coverage and lower deductibles for the higher-price plans.

“The thing to know is the subsidies are still there, they just aren’t the increased subsidies,” Briles told the Daily Sitka Sentinel last week. “People who have income less than 400% the federal poverty level, they’ll still get a subsidy but it’s a reduced subsidy compared to what we’ve had in the last four years.”

For Alaska, 400% of the federal poverty line is $78,200 a year for a single person; $105,720 for a two-person household; $133,240 for three; $160,760 for four; and $156,900 for five.

Briles, who has been helping people with their health insurance questions for about 15 years, first in Oregon and then the past 10 years at SEARHC in Sitka, said her office is open 8 a.m. to 5 p.m. Monday through Friday for callers who need help signing up for coverage.

The number is 855-966-8684.

“A lot of people are saying, ‘if I enroll, can I dis-enroll if nothing does go through (Congress),’” Briles told the Daily Sitka Sentinel last week. “And yes, they can. The big thing is people now have until Jan. 15. They won’t have coverage in January but they literally can wait till Jan. 15 to sign up.”

President Barack Obama signed the Affordable Care Act into law in 2010, creating the federal marketplace for people needing insurance. The significantly higher federal subsidies started in 2021, when President Joe Biden signed the American Rescue Plan into law to help people get through the economic mess caused by the COVID-19 pandemic.

That legislation provided additional subsidies for people making above the 400% threshold and also increased the subsidies for everyone else.